Stress Related Disorders


What is stress?

Stress is the response of an organism aimed at adjusting or dealing with internal or environmental circumstances that disrupt or threaten to disrupt their functioning. The internal or external events that pose a threat to an organism and are challenging are called stressors.

The salience given to the stressor is determined by the individual’s perception of the demands that is posed by the stressors and the actual resources available to cope with it. The initial stress response to a novel stressor is comprised of the sympathetic nervous system activation known as the fight or flight response. In the short run as the body mobilizes its resources to face a stressor it is adaptive however prolonged stress leads to exhaustion which is related to depleting resources of the body and immunosuppression.

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    What happens when we are exposed to intense stress?

    Often when individuals face exceptional stressors like serious injury, some form of violation or threatened death it precipitates an acute stress reaction. Such reactions have a very mixed and varied presentation and comprise of symptoms like intense anxiety, panic, hyperarousal, anger, despair or irritability. The symptoms usually subside with one or two days, however if the symptoms continue to persist then the diagnosis of acute stress reaction is not given.

    What happens when an individual fails to adapt to a stressor?

    When an individual finds it difficult to adapt to a stressful life event leading to a significant change in life it might give rise to subjective distress and emotional turmoil. Usually if the stressor is beyond the individual’s resources to cope and the individuals feels overwhelmed, this might give rise to disturbances in behaviour, conduct and emotions like anxiety or depressive reactions. If such disturbance occurs within 1 month of the occurrence of the stressful event and the symptoms resolve within 6 months and interfere with various domains of functioning it is called an adjustment disorder.

    What are the features of post-traumatic stress disorder?

    Post-traumatic stress disorder is a delayed or protracted response to an extremely stressful event, the symptoms my arise after weeks or months of a traumatic events but mostly within 6 months. The disorder arises when an individual encounters a stressful event of a catastrophic nature such as combat, violent death of others, rape or crime. Typically, an individual experiences intrusive recollection or flashback of the stressful event wherein they feel like they are revisiting or reliving the trauma. There is conscious avoidance of the stimuli, memories and reminders associated with the trauma and the person experiences emotional numbing or detachment. The sufferer might demonstrate hypervigilance, find it difficult to concentrate, might get easily startled, experience irritability and unprovoked anger. Sleep disturbances are often coupled with disturbing nightmares related to the event. Further the thinking of the individuals becomes predominantly negative often coloured by distorted beliefs like self-blame and threatening view of the world. Strong negative emotions, suicidal ideation, emotional detachment, lack of interest and pleasure in different activities are not uncommon in people with PTSD.

    What are the treatment options available for stress related disorders?

    Both pharmacological and non-pharmacological evidence-based treatments are available for stress related disorders.

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    rTMS in
    Stress Related Disorders

    • The man should be the sexual leader
    • Masturbation is wrong
    • A woman should not initiate sex
    • Men should not express their emotions
    • A woman should always have sex when her partner makes sexual
    • approaches
    • All physical contact must lead to sex
    • Good sex leads to a wild orgasm
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    • Sex equals intercourse

    Medications in
    Stress Related Disorders

    • Sex happens automatically
    • A `respectable’ woman should not enjoy sex too much and should
    • certainly never masturbate
    • All other couples have sex several times a week; have orgasm every time
    • they have sex & orgasm simultaneously
    • There must be something wrong with the relationship if sex is not good
    • Cultural beliefs about formation of Semen and genital secretions

    Psychotherapy in
    Stress Related Disorders

    • Role of ‘Physical strength’ or ‘Muscle power’ in sexual performance
    • Size of the penis
    • Circumcision and sexual performance
    • Bending of Penis
    • Vasectomy/tubectomy decreases sexual potency
    • Drugs enhance sexual potency in normal persons
    • Porn increases sexual drive


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